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Contact Lens after Corneal Transplant – Trying a Mini-Scleral

Well, after a fair bit of anxiety and dread, I found my visit to Koffler Vision Group* for the fitting of a new mini-scleral RGP contact lens on my grafted eye to be quite uneventful.  We tried several diameters and shapes until one felt, well, like it wasn’t there.  (*My choice for contact fitting in Lexington.  I’m still Dr. Holland’s patient.  I would link to their site but it is not great and crashed my browser twice.  I will link to their Google Place page though)

Turns out the one with most comfort was a mini-scleral.

I hadn’t considered mini-scleral for my grafted eye, but it makes sense.  It forms a “helmet” over the graft and rests well outside my cornea.  It keeps the corneal hydrated and provides good vision.  I think I had put mini-sclerals out of my head after my less-than-stellar experience with them before my graft.  But that was not due to the lens, it was due to the cone and abrasiveness.

Anyway, I have my lens ordered and will post again when I get it in.  As usual, the Koffler staff were terrific.  By the way, Dr. Koffler was my second choice for my graft – but I just clicked better with Dr. Holland’s attitude about DALK options.  I feel confident either would do a great job, especially on a PK or other surgery.  I did apologize for being such a grump during my last visit to them 2 years ago (I was frustrated with trying to find a contact lens with a steep cone.)

Oh yes, they did a new topography.  Said it was “beautiful.”

 
 

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New – DALK Transplant Chronology

Quick post to let you know that I just made a new page which covers the chronology from my first Dr. appt to one year after the surgery.  Same posts, but in chronological order.

http://corneanews.com/about-kerataconus/chronology/

 

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DALK Transplant – One Year On

photo by Celia Clark

March 9th is the anniversary of my DALK transplant in my left eye, the subject of this blog.  I’m posting a bit early as I have a few moments.  As of one year, I am thrilled that I had the surgery – and forever grateful to the donor and their family.  I’m certain that the posts will slow down now unless I have good reason to post – changes, vision, etc. but I want to thank you for being a part of my story.  I will still monitor for comments and do my best to offer a layperson’s response.  When reading the story – try to go back in time and read the older posts first.

I will be returning to Dr. Holland in a month or so, and I think he’ll be asking me if I was fitted for contacts.  Thus far, I have not built the courage to put anything on my grafted eye.  Soon I will.  I am going to get a new glasses prescription first from my regular eye doctor.  It will be amazing to be able to see with glasses, and I’m thinking that will prompt me to move forward with a RGP lens (Dr. Holland’s recommendation.)  I’m in the primary rejection period for DALK – so am extra vigilant for the RSVP symptoms.  So far, all’s well.

One little aside:

Sometimes we all just forget how precious life is.  How precious love is.  My DALK eye has not forgotten how to shed a tear.  I’m sure those tears are a combination of my own and the loved ones of the donor.  Take today and give someone in your life a hug or a thank you.  It’s easy.  Sign your donor card.  That’s easy, too.

I want to thank my wonderful wife Heather for all of her support, both before and after the surgery.  She was my crutch when I was in pain and always was there to give me the support that only a truly caring wife could give.  She was awake with me that night after surgery when I thought everything was going wrong.  We went on a date recently – at night – and I could see her clearly in the dim dinner light.  Candle fumes used to burn like fire.  Not this time.   I drove there and back – dark outside.  The eye didn’t even come into play.  It was just our date.  This is the combined gift of the donor and my good fortune for meeting her.

 
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Posted by on March 4, 2012 in Diary Entries, Recovery, Surgery-Story

 

11 Month Checkup – Graft Clear, Pressure Down – “Go” for Contact Fitting

Had a good appointment with Dr. Holland today.  Especially amazing was the clarity I got on the vision test.  We went through the usual blur-blur-blur series as the technician flipped lenses and asked “now?”.. “now?”…”now?”   Here we go again… but then, almost startlingly, she flipped a lens and the eye chart snapped into focus.  “Whoa!” I said.  “Ah, we found the sweet spot” she said.  In 15 years I’ve never seen so clearly through that eye and any correction device.  It was almost overwhelming.

Dr. Holland examined the graft and said it was completely clear and that my eye pressure was down.  I’m reducing the pressure medicines to once daily, and staying off the steroids.  I’m reminded that I am at the peak rejection period for my graft (many, including me, thought that the rejection period peaks right after surgery, but it doesn’t.)

I have bad nearsightedness, even with the astigmatism getting resolved, so vision correction will be part of this plan.  It’s time you could get fitted for a RGP lens….   that scares me.  I have this graft which I have been treating like a delicate piece of crystal.. and now I’m to put a lens on it?   I’ll have to get over this.  Will schedule my fitting in the next couple of weeks.   There is still a possbility that I’ll go with PRK if recommended.

No sutures out this time – and the ones in there now may remain a while.

Next Appt, early Spring.

 
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Posted by on January 27, 2012 in Diary Entries, Dr. Visits, Recovery, Vision Improvements

 

Little Things: Holiday Lights without Keratoconus Halos

Keratoconus distortion at night - goneMy latest observation about the little things that are different since my DALK corneal transplant surgery comes this holiday season.  This year, I’m seeing holiday lighting as it’s mean to be seen – with pinpoints of color.   Not only were they hard to see with Keratoconus, but I was unable to drive around at night to look.   If I close my right eye, I still get the slightest echoing of pinpoints, but with both eyes, my brain filters that out.  I think the blurring that remains is because I’ve no corrective lens yet on the left eye.

Coming up:  I will be halting steroids in a week or so.

 
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Posted by on December 23, 2011 in Little Things That are Better

 

Tip for Corneal Suture Removal Antibiotics – Saving a few bucks

When you are in recovery from corneal transplant, your doctor will begin removing sutures – a few at a time each visit (providing everything is going well.)  Each time you leave you’ll be asked to drop antibiotics for 3-4 days several times per day.   A tiny amount, all in all.

The tip I have is this… ask the doctor or assistants if you can have a sample antibiotic (left by drug reps) rather than a prescription.  The samples have just the right number of drops for 4×3 or 3×3 and are meant to be given away for free.  This can save you the cost of the antibiotics and a trip to the drug store.   Even ask them to give you several bottles to be used on the subsequent visit (they have a decent shelf life.)

The doctors can get more, trust me.

This might save you $30-40 per visit.Antibiotics for Corneal Transplant Suture removal

 
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Posted by on November 20, 2011 in Surgery-Story, Tips

 

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Corneal Transplant Surgery – 8-month Follow Up – Steroids to Stop in 6 Weeks.

Post Corneal Transplant Topography 8 monthsToday I went in to Cincinnati Eye Institute for my 8-month follow up with Doctor Edward Holland.   The visit followed the same routine as before – corneal surface scan, vision check, pressure check, doctor chat, and suture removal.

My vision is not changed much – and the topography showed that my astigmatism has shifted axis, and Dr. Holland adjusted his suture removal strategy.  I had two sutures out today, which was quick and painless.   My eye pressure was in the normal range and my optic nerve looked just fine.   He told me not to worry about the eye pressure as long as the optic nerve looked good.

The only big news is that in 6 weeks, I’ll be stopping my steroid drops!  This is a bit early and reflects the fact that my cornea is “crystal clear.”   I’m to watch for inflamation around the graft, but none is expected.

I hate late morning appointments.  I left Lexington at 8:30 and wasn’t back until 2:30.  My next appt is at 7:55 AM.  I’ll probably be back in Lexington by 11:00.

 
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Posted by on November 17, 2011 in Dr. Visits, Recovery, Surgery-Story

 

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Anime, Manga, Pop-Star Contact Lenses – A great way to damage your cornea

My daughter is totally into Anime and Manga characters, so I’m going to pass this through to my readers…  Please share this with those you know with tweens or teens.

Postscript:  Apparently these lenses are now making their way into the child pageant circuit.  Unbelievable!!!

FDA issues warning about decorative contact lenses

Silver Spring, MD – People who use decorative contact lenses as part of their Halloween costumes should consider risks such as an eye infection, cornea damage, vision loss and blindness, according to a consumer update released Oct. 12 by the Food and Drug Administration.

Classified as medical devices, decorative lenses must be specially designed and fitted to a patient’s eyes and are not “one size fits all,” according to FDA. The agency warns consumers to be wary of vendors that do not require a prescription or provide thorough instruction for the lenses.

[youtube http://www.youtube.com/watch?v=H45GYPAuTdg]

FDA recommends the following for people wearing decorative lenses this Halloween season:

  • Schedule an appointment with a licensed eye doctor, who can properly measure your eyes and provide a valid prescription.
  • Follow up with a doctor if you experience redness, pain or a decrease in vision.
  • Practice proper usage and storage instructions.
  • FDA also warns consumers about anime-inspired lenses, which typically are larger than normal contact lenses and not FDA-approved.
 
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Posted by on October 22, 2011 in Interesting Stuff

 

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DALK Checkup – A Few New Nuggets of Info

Lexington Farmer's Market

Well, today was a routine checkup.  Topography, pressure check, eye test.  Pretty much the same as the last time.  Dr. Holland removed two sutures as we continue “suture roulette.”   The graft looks great, and we’re right “on track.”

I did learn a couple of things today:

  • Peak rejection time is 8 months out from surgery.   This is for PK or DALK.  I thought it would be earlier.  This means that I must be extra diligent for RSVP symptoms between now and early next year.
  • The first sign of rejection will be redness and light sensitivity, not pain.   You should never wait for the pain if redness and pain are present.
  • When Restasis is part of your post-op drops routine, you should usually use it last.   So, for me, it’s Steroids, Pressure Med, then Restasis.
  • He suggested that I might go ahead and use Restasis in my right eye if allergies get bad again.  I think I’m through the worst of Fall allergies, however.
That’s it.
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Oh, I really do appreciate all the messages I get about how much people are enjoying the blog.  Thanks much.
 
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Posted by on September 29, 2011 in Dr. Visits, Surgery-Story

 

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Allergy Season, Ughhh!

 

 

The eyes are itching something awful right now.    I think the Restasis is helping my grafted eye stay less itchy than my ungrafted one.  Eye rubbing has been partially implicated as a cause for Keratoconus, so those of us who suffer with allergies must remain vigilant – possibly even wearing glasses as a reminder – to avoid rubbing the eyes.   Lucky for me, it happens only a couple of times per year for 2-3 weeks.

The view from my iPhone allergy system:

20110902-014305.jpg

 
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Posted by on September 2, 2011 in Diary Entries

 

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